Search results for: multidisciplinary investigation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5242

Search results for: multidisciplinary investigation

4582 Design and Simulation of All Optical Fiber to the Home Network

Authors: Rahul Malhotra

Abstract:

Fiber based access networks can deliver performance that can support the increasing demands for high speed connections. One of the new technologies that have emerged in recent years is Passive Optical Networks. This paper is targeted to show the simultaneous delivery of triple play service (data, voice and video). The comparative investigation and suitability of various data rates is presented. It is demonstrated that as we increase the data rate, number of users to be accommodated decreases due to increase in bit error rate.

Keywords: BER, PON, TDMPON, GPON, CWDM, OLT, ONT

Procedia PDF Downloads 555
4581 Impact of a Structured Antimicrobial Stewardship Program in a North-East Italian Hospital

Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

Abstract:

A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

Procedia PDF Downloads 157
4580 Mode II Fracture Toughness of Hybrid Fiber Reinforced Concrete

Authors: H. S. S Abou El-Mal, A. S. Sherbini, H. E. M. Sallam

Abstract:

Mode II fracture toughness (KIIc) of fiber reinforced concrete has been widely investigated under various patterns of testing geometries. The effect of fiber type, concrete matrix properties, and testing mechanisms were extensively studied. The area of hybrid fiber addition shows a lake of reported research data. In this paper an experimental investigation of hybrid fiber embedded in high strength concrete matrix is reported. Three different types of fibers; namely steel (S), glass (G), and polypropylene (PP) fibers were mixed together in four hybridization patterns, (S/G), (S/PP), (G/PP), (S/G/PP) with constant cumulative volume fraction (Vf) of 1.5%. The concrete matrix properties were kept the same for all hybrid fiber reinforced concrete patterns. In an attempt to estimate a fairly accepted value of fracture toughness KIIc, four testing geometries and loading types are employed in this investigation. Four point shear, Brazilian notched disc, double notched cube, and double edge notched specimens are investigated in a trial to avoid the limitations and sensitivity of each test regarding geometry, size effect, constraint condition, and the crack length to specimen width ratio a/w. The addition of all hybridization patterns of fiber reduced the compressive strength and increased mode II fracture toughness in pure mode II tests. Mode II fracture toughness of concrete KIIc decreased with the increment of a/w ratio for all concretes and test geometries. Mode II fracture toughness KIIc is found to be sensitive to the hybridization patterns of fiber. The (S/PP) hybridization pattern showed higher values than all other patterns, while the (S/G/PP) showed insignificant enhancement on mode II fracture toughness (KIIc). Four point shear (4PS) test set up reflects the most reliable values of mode II fracture toughness KIIc of concrete. Mode II fracture toughness KIIc of concrete couldn’t be assumed as a real material property.

Keywords: fiber reinforced concrete, Hybrid fiber, Mode II fracture toughness, testing geometry

Procedia PDF Downloads 327
4579 Data Transformations in Data Envelopment Analysis

Authors: Mansour Mohammadpour

Abstract:

Data transformation refers to the modification of any point in a data set by a mathematical function. When applying transformations, the measurement scale of the data is modified. Data transformations are commonly employed to turn data into the appropriate form, which can serve various functions in the quantitative analysis of the data. This study addresses the investigation of the use of data transformations in Data Envelopment Analysis (DEA). Although data transformations are important options for analysis, they do fundamentally alter the nature of the variable, making the interpretation of the results somewhat more complex.

Keywords: data transformation, data envelopment analysis, undesirable data, negative data

Procedia PDF Downloads 20
4578 Multidisciplinary Approach for a Tsunami Reconstruction Plan in Coquimbo, Chile

Authors: Ileen Van den Berg, Reinier J. Daals, Chris E. M. Heuberger, Sven P. Hildering, Bob E. Van Maris, Carla M. Smulders, Rafael Aránguiz

Abstract:

Chile is located along the subduction zone of the Nazca plate beneath the South American plate, where large earthquakes and tsunamis have taken place throughout history. The last significant earthquake (Mw 8.2) occurred in September 2015 and generated a destructive tsunami, which mainly affected the city of Coquimbo (71.33°W, 29.96°S). The inundation area consisted of a beach, damaged seawall, damaged railway, wetland and old neighborhood; therefore, local authorities started a reconstruction process immediately after the event. Moreover, a seismic gap has been identified in the same area, and another large event could take place in the near future. The present work proposed an integrated tsunami reconstruction plan for the city of Coquimbo that considered several variables such as safety, nature & recreation, neighborhood welfare, visual obstruction, infrastructure, construction process, and durability & maintenance. Possible future tsunami scenarios are simulated by means of the Non-hydrostatic Evolution of Ocean WAVEs (NEOWAVE) model with 5 nested grids and a higher grid resolution of ~10 m. Based on the score from a multi-criteria analysis, the costs of the alternatives and a preference for a multifunctional solution, the alternative that includes an elevated coastal road with floodgates to reduce tsunami overtopping and control the return flow of a tsunami was selected as the best solution. It was also observed that the wetlands are significantly restored to their former configuration; moreover, the dynamic behavior of the wetlands is stimulated. The numerical simulation showed that the new coastal protection decreases damage and the probability of loss of life by delaying tsunami arrival time. In addition, new evacuation routes and a smaller inundation zone in the city increase safety for the area.

Keywords: tsunami, Coquimbo, Chile, reconstruction, numerical simulation

Procedia PDF Downloads 241
4577 Evaluation of Health Risk Degree Arising from Heavy Metals Present in Drinking Water

Authors: Alma Shehu, Majlinda Vasjari, Sonila Duka, Loreta Vallja, Nevila Broli

Abstract:

Humans consume drinking water from several sources, including tap water, bottled water, natural springs, filtered tap water, etc. The quality of drinking water is crucial for human survival given the fact that the consumption of contaminated drinking water is related to many diseases and deaths all over the world. This study represents the investigation of the quality and health risks of different types of drinking waters being consumed by the population in Albania, arising from heavy metals content. Investigated water included industrialized water, tap water, and spring water. In total, 20 samples were analyzed for the content of Pb, Cd, Cr, Ni, Cu, Fe, Zn, Al, and Mn. Determination of each metal concentration in selected samples was conducted by atomic absorption spectroscopy method with electrothermal atomization, GFAAS. Water quality was evaluated by comparing the obtained metals concentrations with the recommended maximum limits, according to the European Directive (98/83/EC) and Guidelines for Drinking Water Quality (WHO, 2017). Metal Index (MI) was used to assess the overall water quality due to heavy metals content. Health risk assessment was conducted based on the recommendations of the USEPA (1996), human health risk assessment, via ingestion. Results of this investigation showed that Al, Ni, Fe, and Cu were the metals found in higher concentrations while Cd exhibited the lowest concentration. Among the analyzed metals, Al (one sample) and Ni (in five samples) exceeded the maximum allowed limit. Based on the pollution metal index, it was concluded that the overall quality of Glina bottled water can be considered as toxic to humans, while the quality of bottled water (Trebeshina) was classified as moderately toxic. Values of health risk quotient (HQ) varied between 1x10⁻⁶-1.3x10⁻¹, following the order Ni > Cd > Pb > Cu > Al > Fe > Zn > Mn. All the values were lower than 1, which suggests that the analyzed samples exhibit no health risk for humans.

Keywords: drinking water, health risk assessment, heavy metals, pollution index

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4576 Improvement of Healthcare Quality and Psychological Stress Relieve for Transition Program in Intensive Care Units

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

Abstract:

Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

Procedia PDF Downloads 84
4575 Investigation of the Corroded Steel Beam

Authors: Hesamaddin Khoshnoodi, Ahmad Rahbar Ranji

Abstract:

Corrosion in steel structures is one of the most important issues that should be considered in designing and constructing. Corrosion reduces the cross section and load capacity of element and leads to costly damage of structures. In this paper, the corrosion has been modeled for moment stresses. Moreover, the steel beam has been modeled using ABAQUS advanced finite element software. The conclusions of this study demonstrated that the displacement of the analyzed composite steel girder bridge might increase.

Keywords: Abaqus, Corrosion, deformation, Steel Beam

Procedia PDF Downloads 354
4574 Vertebrate Model to Examine the Biological Effectiveness of Different Radiation Qualities

Authors: Rita Emília Szabó, Róbert Polanek, Tünde Tőkés, Zoltán Szabó, Szabolcs Czifrus, Katalin Hideghéty

Abstract:

Purpose: Several feature of zebrafish are making them amenable for investigation on therapeutic approaches such as ionizing radiation. The establishment of zebrafish model for comprehensive radiobiological research stands in the focus of our investigation, comparing the radiation effect curves of neutron and photon irradiation. Our final aim is to develop an appropriate vertebrate model in order to investigate the relative biological effectiveness of laser driven ionizing radiation. Methods and Materials: After careful dosimetry series of viable zebrafish embryos were exposed to a single fraction whole-body neutron-irradiation (1,25; 1,875; 2; 2,5 Gy) at the research reactor of the Technical University of Budapest and to conventional 6 MeV photon beam at 24 hour post-fertilization (hpf). The survival and morphologic abnormalities (pericardial edema, spine curvature) of each embryo were assessed for each experiment at 24-hour intervals from the point of fertilization up to 168 hpf (defining the dose lethal for 50% (LD50)). Results: In the zebrafish embryo model LD50 at 20 Gy dose level was defined and the same lethality were found at 2 Gy dose from the reactor neutron beam resulting RBE of 10. Dose-dependent organ perturbations were detected on macroscopic (shortening of the body length, spine curvature, microcephaly, micro-ophthalmia, micrognathia, pericardial edema, and inhibition of yolk sac resorption) and microscopic (marked cellular changes in skin, cardiac, gastrointestinal system) with the same magnitude of dose difference. Conclusion: In our observations, we found that zebrafish embryo model can be used for investigating the effects of different type of ionizing radiation and this system proved to be highly efficient vertebrate model for preclinical examinations.

Keywords: ionizing radiation, LD50, relative biological effectiveness, zebrafish embryo

Procedia PDF Downloads 309
4573 Adult Language Learning in the Institute of Technology Sector in the Republic of Ireland

Authors: Una Carthy

Abstract:

A recent study of third level institutions in Ireland reveals that both age and aptitude can be overcome by teaching methodologies to motivate second language learners. This PhD investigation gathered quantitative and qualitative data from 14 Institutes of Technology over a three years period from 2011 to 2014. The fundamental research question was to establish the impact of institutional language policy on attitudes towards language learning. However, other related issues around second language acquisition arose in the course of the investigation. Data were collected from both lectures and students, allowing interesting points of comparison to emerge from both datasets. Negative perceptions among lecturers regarding language provision were often associated with the view that language learning belongs to primary and secondary level and has no place in third level education. This perception was offset by substantial data showing positive attitudes towards adult language learning. Lenneberg’s Critical Age Theory postulated that the optimum age for learning a second language is before puberty. More recently, scholars have challenged this theory in their studies, revealing that mature learners can and do succeed at learning languages. With regard to aptitude, a preoccupation among lecturers regarding poor literacy skills among students emerged and was often associated with resistance to second language acquisition. This was offset by a preponderance of qualitative data from students highlighting the crucial role which teaching approaches play in the learning process. Interestingly, the data collected regarding learning disabilities reveals that, given the appropriate learning environments, individuals can be motivated to acquire second languages, and indeed succeed at learning them. These findings are in keeping with other recent studies regarding attitudes towards second language learning among students with learning disabilities. Both sets of findings reinforce the case for language policies in the Institute of Technology (IoTs). Supportive and positive learning environments can be created in third level institutions to motivate adult learners, thereby overcoming perceived obstacles relating to age and aptitude.

Keywords: age, aptitude, second language acquisition, teaching methodologies

Procedia PDF Downloads 123
4572 Planckian Dissipation in Bi₂Sr₂Ca₂Cu₃O₁₀₋δ

Authors: Lalita, Niladri Sarkar, Subhasis Ghosh

Abstract:

Since the discovery of high temperature superconductivity (HTSC) in cuprates, several aspects of this phenomena have fascinated physics community. The most debated one is the linear temperature dependence of normal state resistivity over wide range of temperature in violation of with Fermi liquid theory. The linear-in-T resistivity (LITR) is the indication of strongly correlated metallic, known as “strange metal”, attributed to non Fermi liquid theory (NFL). The proximity of superconductivity to LITR suggests that there may be underlying common origin. The LITR has been shown to be due to unknown dissipative phenomena, restricted by quantum mechanics and commonly known as ‘‘Planckian dissipation” , the term first coined by Zaanen and the associated inelastic scattering time τ and given by 1/τ=αkBT/ℏ, where ℏ, kB and α are reduced Planck’s constant, Boltzmann constant and a dimensionless constant of order of unity, respectively. Since the first report, experimental support for α ~ 1 is appearing in literature. There are several striking issues which remain to be resolved if we desire to find out or at least get a clue towards microscopic origin of maximal dissipation in cuprates. (i) Universality of α ~ 1, recently some doubts have been raised in some cases. (ii) So far, Planckian dissipation has been demonstrated in overdoped Cuprates, but if the proximity to quantum criticality is important, then Planckian dissipation should be observed in optimally doped and marginally underdoped cuprates. The link between Planckian dissipation and quantum criticality still remains an open problem. (iii) Validity of Planckian dissipation in all cuprates is an important issue. Here, we report reversible change in the superconducting behavior of high temperature superconductor Bi2Sr2Ca2Cu3O10+δ (Bi-2223) under dynamic doping induced by photo-excitation. Two doped Bi-223 samples, which are x = 0.16 (optimal-doped), x = 0.145 (marginal-doped) have been used for this investigation. It is realized that steady state photo-excitation converts magnetic Cu2+ ions to nonmagnetic Cu1+ ions which reduces superconducting transition temperature (Tc) by killing superfluid density. In Bi-2223, one would expect the maximum of suppression of Tc should be at charge transfer gap. We have observed suppression of Tc starts at 2eV, which is the charge transfer gap in Bi-2223. We attribute this transition due to Cu-3d9(Cu2+) to Cu-3d10(Cu+), known as d9 − d10 L transition, photoexcitation makes some Cu ions in CuO2 planes as spinless non-magnetic potential perturbation as Zn2+ does in CuO2 plane in case Zn-doped cuprates. The resistivity varies linearly with temperature with or without photo-excitation. Tc can be varied by almost by 40K be photoexcitation. Superconductivity can be destroyed completely by introducing ≈ 2% of Cu1+ ions for this range of doping. With this controlled variation of Tc and resistivity, detailed investigation has been carried out to reveal Planckian dissipation underdoped to optimally doped Bi-2223. The most important aspect of this investigation is that we could vary Tc dynamically and reversibly, so that LITR and associated Planckian dissipation can be studied over wide ranges of Tc without changing the doping chemically.

Keywords: linear resistivity, HTSC, Planckian dissipation, strange metal

Procedia PDF Downloads 59
4571 An Investigation Enhancing E-Voting Application Performance

Authors: Aditya Verma

Abstract:

E-voting using blockchain provides us with a distributed system where data is present on each node present in the network and is reliable and secure too due to its immutability property. This work compares various blockchain consensus algorithms used for e-voting applications in the past, based on performance and node scalability, and chooses the optimal one and improves on one such previous implementation by proposing solutions for the loopholes of the optimally working blockchain consensus algorithm, in our chosen application, e-voting.

Keywords: blockchain, parallel bft, consensus algorithms, performance

Procedia PDF Downloads 167
4570 Drug Delivery to Solid Tumor: Effect of Dynamic Capillary Network Induced by Tumor

Authors: Mostafa Sefidgar, Kaamran Raahemifar, Hossein Bazmara, Madjid Soltani

Abstract:

The computational methods provide condition for investigation related to the process of drug delivery, such as convection and diffusion of drug in extracellular matrices, and drug extravasation from microvascular. The information of this process clarifies the mechanisms of drug delivery from the injection site to absorption by a solid tumor. In this study, an advanced numerical method is used to solve fluid flow and solute transport equations simultaneously to show how capillary network structure induced by tumor affects drug delivery. The effect of heterogeneous capillary network induced by tumor on interstitial fluid flow and drug delivery is investigated by this multi scale method. The sprouting angiogenesis model is used for generating capillary network induced by tumor. Fluid flow governing equations are implemented to calculate blood flow through the tumor-induced capillary network and fluid flow in normal and tumor tissues. The Starling’s law is used for closing this system of equations and coupling the intravascular and extravascular flows. Finally, convection-diffusion-reaction equation is used to simulate drug delivery. The dynamic approach which changes the capillary network structure based on signals sent by hemodynamic and metabolic stimuli is used in this study for more realistic assumption. The study indicates that drug delivery to solid tumors depends on the tumor induced capillary network structure. The dynamic approach generates the irregular capillary network around the tumor and predicts a higher interstitial pressure in the tumor region. This elevated interstitial pressure with irregular capillary network leads to a heterogeneous distribution of drug in the tumor region similar to in vivo observations. The investigation indicates that the drug transport properties have a significant role against the physiological barrier of drug delivery to a solid tumor.

Keywords: solid tumor, physiological barriers to drug delivery, angiogenesis, microvascular network, solute transport

Procedia PDF Downloads 312
4569 Optimization of Titanium Leaching Process Using Experimental Design

Authors: Arash Rafiei, Carroll Moore

Abstract:

Leaching process as the first stage of hydrometallurgy is a multidisciplinary system including material properties, chemistry, reactor design, mechanics and fluid dynamics. Therefore, doing leaching system optimization by pure scientific methods need lots of times and expenses. In this work, a mixture of two titanium ores and one titanium slag are used for extracting titanium for leaching stage of TiO2 pigment production procedure. Optimum titanium extraction can be obtained from following strategies: i) Maximizing titanium extraction without selective digestion; and ii) Optimizing selective titanium extraction by balancing between maximum titanium extraction and minimum impurity digestion. The main difference between two strategies is due to process optimization framework. For the first strategy, the most important stage of production process is concerned as the main stage and rest of stages would be adopted with respect to the main stage. The second strategy optimizes performance of more than one stage at once. The second strategy has more technical complexity compared to the first one but it brings more economical and technical advantages for the leaching system. Obviously, each strategy has its own optimum operational zone that is not as same as the other one and the best operational zone is chosen due to complexity, economical and practical aspects of the leaching system. Experimental design has been carried out by using Taguchi method. The most important advantages of this methodology are involving different technical aspects of leaching process; minimizing the number of needed experiments as well as time and expense; and concerning the role of parameter interactions due to principles of multifactor-at-time optimization. Leaching tests have been done at batch scale on lab with appropriate control on temperature. The leaching tank geometry has been concerned as an important factor to provide comparable agitation conditions. Data analysis has been done by using reactor design and mass balancing principles. Finally, optimum zone for operational parameters are determined for each leaching strategy and discussed due to their economical and practical aspects.

Keywords: titanium leaching, optimization, experimental design, performance analysis

Procedia PDF Downloads 372
4568 Investigation of Input Energy Efficiency in Corn (KSC704) Farming in Khoy City, Iran

Authors: Nasser Hosseini

Abstract:

Energy cycle is one of the essential points in agricultural ecosystems all over the world. Corn is one of the important products in Khoy city. Knowing input energy level and evaluating output energy from farms to reduce energy and increase efficiency in farms is very important if one can reduce input energy level into farms through the indices like poisons, fertilization, tractor energy and labour force. In addition to the net income of the farmers, this issue would play a significant role in preserving farm ecosystem from pollution and wrecker factors. For this reason, energy balance sheet in corn farms as well as input and output energy in 2012-2013 were researched by distributing a questionnaire among farmers in various villages in Khoy city. Then, the input energy amount into farms via energy-consuming factors, mentioned above, with regard to special coefficients was computed. Energy was computed on the basis of seed corn function, chemical compound and its content as well. In this investigation, we evaluated the level of stored energy 10792831 kcal per hectare. We found out that the greatest part of energy depended on irrigation which has 5136141.8 kcal and nitrate fertilizer energy with 2509760 kcal and the lowest part of energy depended on phosphor fertilizer, the rate of posited energy equaled 36362500 kcal and energy efficiency on the basis of seed corn function were estimated as 3.36. We found some ways to reduce consumptive energy in farm and nitrate fertilizer and, on the other hand, to increase balance sheet. They are, to name a few, using alternative farming and potherbs for biological stabilizing of nitrogen and changing kind of fertilizers such as urea fertilizer with sulphur cover, and using new generation of irrigation, the compound of water super absorbent like colored hydrogels and using natural fertilizer to preserve.

Keywords: corn (KSC704), output and input, energy efficiency, Khoy city

Procedia PDF Downloads 440
4567 Determinants of Customer Satisfaction: The case of Abyssinia Bank Customers in Addis Ababa Ethiopia

Authors: Yosef Ferede Bogale

Abstract:

The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality service risk, banks

Procedia PDF Downloads 123
4566 Physical Activity and Sport Research with People with Impairments: Oppression–Empowerment Continuum

Authors: Gyozo Molnar, Nancy Spencer-Cavaliere

Abstract:

Research in the area of physical activity and sport, while becoming multidisciplinary, is still dominated by post-positivist approaches that have the tendency to position the researcher as an expert and the participant as subordinate thereby perpetuating an unequal balance of power. Despite physical activity’s and sport’s universal appeal, their historic practices have excluded particular groups of people who assumed lesser forms of human capital. Adapted physical activity (APA) is a field that has responded to those segregations with specific application and relevance to people with impairments. Nevertheless, to date, similar to physical activity and sport, research in APA is still dominated by post-positivist epistemology. Stemming from this, there is gradually growing criticism within the field related to the abundance of research ‘on’ people with impairments and lack of research ‘with’ and ‘by’ people with impairments. Furthermore, research questions in the field are most often pursued from a single axis of analysis and constructed by non-disabled researchers. Concurrently, while calls for interdisciplinary approaches to understanding disability are growing in popularity, there is also a clear need to take an intersectionality-informed research methodology to understanding physical activity and sport and power (im)balances therein. In other words, impairment needs to be considered in conjunction with other socially and politically constructed and historically embedded differences such as gender, race, class, etc. when analyzing physical activity and sport experiences for people with impairments. Moreover, it is reasonable to argue that non-disabled researchers must recognize and theorize ableism in its complicated intersectional manifestation to show the structural constraints that disabled scholars face in the field. Consequently, this presentation will offer an alternative approach that acknowledges and prioritizes the perspectives and experiences of people with impairments to expand the field of APA. As such, the importance of broadening epistemologies in APA and prioritizing an appreciation for multiple bits of knowledge of people with impairments through intersections of social locations (e.g., gender, race, class) will be considered.

Keywords: adapted physical activity, disability, intersectionality, post-positivist, power imbalances

Procedia PDF Downloads 237
4565 Determinants of Customer Satisfaction: The Case of Abyssinia Bank Customers in Addis Ababa Ethiopia

Authors: Yosef Ferede Bogale

Abstract:

The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality services risk, bank

Procedia PDF Downloads 62
4564 Condition Monitoring of a 3-Ø Induction Motor by Vibration Spectrum Analysis Using FFT Analyzer, a Case Study

Authors: Adinarayana S., Sudhakar I.

Abstract:

Energy conversion is one of the inevitable parts of any industries. It involves either conversion of mechanical energy in to electrical or vice versa. The later conversion of energy i.e. electrical to mechanical emphasizes the need of motor. Statistics reveals, about 8 % of industries’ annual turnover met on maintenance. Thus substantial numbers of efforts are required to minimize in incurring expenditure met towards break down maintenance. Condition monitoring is one of such techniques based on vibration widely used to recognize premature failures and paves a way to minimize cumbersome involved during breakdown of machinery. The present investigation involves a case study of squirrel cage induction motor (frequently in the electro machines) has been chosen for the conditional monitoring to predict its soundness on the basis of results of FFT analyser. Accelerometer which measures the acceleration converts in to impulses by FFT analyser generates vibration spectrum and time spectrum has been located at various positions on motor under different conditions. Results obtained from the FFT analyser are compared to that of ISO standard vibration severity charts are taken to predict the preventative condition of considered machinery. Initial inspection of motor revealed that stator faults, broken end rings in rotor, eccentricity faults and misalignment between bearings are trouble shootings areas for present investigation. From the results of the shaft frequencies, it can be perceived that there is a misalignment between the bearings at both the ends. The higher order harmonics of FTF shows the presence of cracks on the race of the bearings at both the ends which are in the incipient stage. Replacement of the bearings at both the drive end (6306) and non drive end (6206) and the alignment check between the bearings in the shaft are suggested as the constructive measures towards preventive maintenance of considered squirrel cage induction motor.

Keywords: FFT analyser, condition monitoring, vibration spectrum, time wave form

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4563 Exploring the Interplay of Attention, Awareness, and Control: A Comprehensive Investigation

Authors: Venkateswar Pujari

Abstract:

This study tries to investigate the complex interplay between control, awareness, and attention in human cognitive processes. The fundamental elements of cognitive functioning that play a significant role in influencing perception, decision-making, and behavior are attention, awareness, and control. Understanding how they interact can help us better understand how our minds work and may even increase our understanding of cognitive science and its therapeutic applications. The study uses an empirical methodology to examine the relationships between attention, awareness, and control by integrating different experimental paradigms and neuropsychological tests. To ensure the generalizability of findings, a wide sample of participants is chosen, including people with various cognitive profiles and ages. The study is structured into four primary parts, each of which focuses on one component of how attention, awareness, and control interact: 1. Evaluation of Attentional Capacity and Selectivity: In this stage, participants complete established attention tests, including the Stroop task and visual search tasks. 2. Evaluation of Awareness Degrees: In the second stage, participants' degrees of conscious and unconscious awareness are assessed using perceptual awareness tasks such as masked priming and binocular rivalry tasks. 3. Investigation of Cognitive Control Mechanisms: In the third phase, reaction inhibition, cognitive flexibility, and working memory capacity are investigated using exercises like the Wisconsin Card Sorting Test and the Go/No-Go paradigm. 4. Results Integration and Analysis: Data from all phases are integrated and analyzed in the final phase. To investigate potential links and prediction correlations between attention, awareness, and control, correlational and regression analyses are carried out. The study's conclusions shed light on the intricate relationships that exist between control, awareness, and attention throughout cognitive function. The findings may have consequences for cognitive psychology, neuroscience, and clinical psychology by providing new understandings of cognitive dysfunctions linked to deficiencies in attention, awareness, and control systems.

Keywords: attention, awareness, control, cognitive functioning, neuropsychological assessment

Procedia PDF Downloads 91
4562 Attracting the North Holidaymaker to Ireland Using Social Media Channels: An Irish Marketing Strategy

Authors: Colm Barcoe, Garvan Whelan

Abstract:

In tourism, engagement has been found to boost awareness of a destination and subsequently increase visits. Customer engagement in this industry is now facilitated by social media. This phenomenon is not very well researched in relation to Ireland and the North American tourism market. The objective of this paper is to present research findings on two related topics; the first is an investigation into the effectiveness of social media channels as components of a digital marketing campaign when promoting Ireland as a brand in North America. Secondly, this study reveals how Irish marketers have embraced social media platforms and channels with an innovative strategy that has successfully attracted growing numbers of US and Canadian holidaymakers to Ireland. A range of methodological approaches was applied in order to achieve the study’s objective. The methods used were both quantitative and qualitative, and the data was obtained from both Irish marketers and North American holidaymakers. Surveys of these holidaymakers in the pre, during and post-trip phases revealed their attitudes towards social media and Ireland as a destination. Semi-structured interviews with those responsible for implementing relationship marketing strategies for this segment provide insight into the effectiveness of social media when used to capitalise on the cultural link between Ireland and North America. Further analysis involved using Nvivo 11+ software to investigate the activities of the Irish destination marketer (DMO) and the engagement of the US and Canadian audiences through a detailed study of social media platform content. The findings from this investigation will extend an under-researched body of literature pertaining to Ireland as a destination and the successful digital marketing campaigns that have achieved exponential growth in this sector over the past five years. The empirical evidence presented also illustrates how the innovative use of social media has assisted the DMO to engage with the North American holidaymaker as part of an effective digital marketing strategy.

Keywords: channels, digital, engagement, marketing, strategies

Procedia PDF Downloads 156
4561 The Effect of Technology on International Marketing Trading Researches and Analysis

Authors: Karim Monir Halim Salib

Abstract:

The article discusses the use of modern technology to achieve environmental marketing goals in business and customer relations. The purpose of this article is to show the possibilities of the application of modern technology. In B2C relationships, marketing departments face challenges arising from the need to quickly segment customers and share information across multiple systems, which seriously hinders the achievement of marketing objectives. Therefore, the Article states that modern IT solutions are used in the marketing of business activities, taking into account environmental objectives. For this reason, its importance in the economic and social development of developing countries has increased. While traditional companies emphasize profit as the most important business principle, social enterprises have to address social issues at the expense of profit. This mindset gives social enterprises more than traditional businesses to meet the needs of those at the bottom of the pyramid. This also poses a great challenge for social business, as social business works for the public good on the one hand and financial stability on the other. Otherwise, the company cannot be evacuated. Cultures are involved in business communication and research. Using the example of language in international relations, the article poses the problem of cultural discourse in management and linguistic and cultural studies. After reviewing current research on language in international relations, this article presents communication methods in the international economy from a linguistic perspective and attempts to explain communication problems in business from the perspective of linguistic research. A step towards multidisciplinary research combining research in management and linguistics.

Keywords: international marketing, marketing mix, marketing research, small and medium-sized enterprises, strategic marketing, B2B digital marketing strategy, digital marketing, digital marketing maturity model, SWOT analysis consumer behavior, experience, experience marketing, marketing employee organizational performance, internal marketing, internal customer, direct marketing, mobile phones mobile marketing, Sms advertising.

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4560 Streamlining Coastal Defense: Investigating the Impact of Seawall Geometry on Wave Loads

Authors: Ahmadreza Ebadati, Asaad Y. Shamseldin, Amin Ghadirian

Abstract:

Seawall geometry plays a crucial role in mitigating wave impacts, though detailed exploration of its manipulation is limited. This study delves into the effects of varying cross-shore seawall geometry on the dynamics of wave impacts, with a particular focus on vertical seawalls. Inspired by foundational insights linking seawall shape to hydraulic efficiency, this investigation centres on how alterations in seawall geometry can influence wave energy dissipation and subsequent wave impacts. The study investigates the 2D interaction of regular waves with a period of 2.1s with a vertical seawall and berm featuring small-scale cross-shore protrusions and recesses. Utilising OpenFOAM® simulations and a k-ω SST turbulence model, this investigation compares results to a base case simulation, which is partially calibrated with experimental data from a flume study. The analysis evaluates various geometric modifications, specifically interchanged protrusions and recesses at different heights and orientations along the seawall. Findings suggest that specific configurations, such as interchanged protrusions and recesses, can mitigate initial impact forces, while certain arrangements may intensify subsequent impacts. Key insights include the identification of geometry configurations that can effectively reduce the force impulse of slamming waves on coastal structures and potentially decrease the frequency and cost of seawall maintenance. This research contributes to the field by advancing the understanding of how seawall geometry influences wave forces and by providing actionable insights for the design of more resilient seawall structures. Further exploration of seawall geometry variation is recommended, advocating additional case studies to optimise designs tailored to specific coastal environments.

Keywords: seawall geometry, wave impact loads, numerical simulation, coastal engineering, wave-structure interaction

Procedia PDF Downloads 49
4559 The Publication Impact of London’s Air Ambulance on the Field of Pre-Hospital Medicine and Its Application to Air Ambulances Internationally: A Bibliometric Analysis

Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

Abstract:

Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

Procedia PDF Downloads 76
4558 Comparative Investigation of Two Non-Contact Prototype Designs Based on a Squeeze-Film Levitation Approach

Authors: A. Almurshedi, M. Atherton, C. Mares, T. Stolarski, M. Miyatake

Abstract:

Transportation and handling of delicate and lightweight objects is currently a significant issue in some industries. Two common contactless movement prototype designs, ultrasonic transducer design and vibrating plate design, are compared. Both designs are based on the method of squeeze-film levitation, and this study aims to identify the limitations, and challenges of each. The designs are evaluated in terms of levitation capabilities, and characteristics. To this end, theoretical and experimental explorations are made. It is demonstrated that the ultrasonic transducer prototype design is better suited to the terms of levitation capabilities. However, the design has some operating and mechanical designing difficulties. For making accurate industrial products in micro-fabrication and nanotechnology contexts, such as semiconductor silicon wafers, micro-components and integrated circuits, non-contact oil-free, ultra-precision and low wear transport along the production line is crucial for enabling. One of the designs (design A) is called the ultrasonic chuck, for which an ultrasonic transducer (Langevin, FBI 28452 HS) comprises the main part. Whereas the other (design B), is a vibrating plate design, which consists of a plain rectangular plate made of Aluminium firmly fastened at both ends. The size of the rectangular plate is 200x100x2 mm. In addition, four rounded piezoelectric actuators of size 28 mm diameter with 0.5 mm thickness are glued to the underside of the plate. The vibrating plate is clamped at both ends in the horizontal plane through a steel supporting structure. In addition, the dynamic of levitation using the designs (A and B) has been investigated based on the squeeze film levitation (SFL). The input apparatus that is used with designs consist of a sine wave signal generator connected to an amplifier type ENP-1-1U (Echo Electronics). The latter has to be utilised to magnify the sine wave voltage that is produced by the signal generator. The measurements of the maximum levitation for three different semiconductor wafers of weights 52, 70 and 88 [g] for design A are 240, 205 and 187 [um], respectively. Whereas the physical results show that the average separation distance for a disk of 5 [g] weight for design B reaches 70 [um]. By using the methodology of squeeze film levitation, it is possible to hold an object in a non-contact manner. The analyses of the investigation outcomes signify that the non-contact levitation of design A provides more improvement than design B. However, design A is more complicated than design B in terms of its manufacturing. In order to identify an adequate non-contact SFL design, a comparison between two common such designs has been adopted for the current investigation. Specifically, the study will involve making comparisons in terms of the following issues: floating component geometries and material type constraints; final created pressure distributions; dangerous interactions with the surrounding space; working environment constraints; and complication and compactness of the mechanical design. Considering all these matters is essential for proficiently distinguish the better SFL design.

Keywords: ANSYS, floating, piezoelectric, squeeze-film

Procedia PDF Downloads 149
4557 The Current Situation of Veterinary Services and a Reform for Enhancing the Veterinary Services in Developing Countries

Authors: Sufian Abdo Jilo

Abstract:

Veterinary services conserve and maintain animal life and improve the living conditions of human beings through improving rural livelihoods and feeding; veterinary services also address global health crises by preventing risks such as emerging pandemic diseases, antimicrobial resistance, contamination of foods, and environmental health problems at their origin. The purpose of this policy brief is to analyze the way veterinary organizations provide services and to propose an optimal organization for veterinary services in developing countries. The current situation of veterinary institutions in developing countries can't counter the challenge related to animal health and productivity. As a result, reorganization, amalgamation, merging, and consolidation of veterinary health services (veterinary clinics, slaughterhouses, quarantine, and veterinary markets) together with the construction of closer veterinary service facilities and the construction of common areas will help institutions to strengthen cooperation among different veterinarians, which is the first steps for the implementation of a One Health platform and multidisciplinary activities. The improvement and reorganization of the veterinary services institutions will also help the veterinary clinics easily obtain various medical chemicals such as blood and rumen from abattoirs, enhance the surveillance of livestock diseases, enable the community to buy healthy animals from the animal market, and help to reduce economic waste. The services can be performed by a small number of veterinarians through a model of specific areas common to all veterinary services. This model improves the skills and knowledge of veterinarians in all aspects of veterinary medicine and saves students and researchers time. Communities or customers can save time by getting all veterinary services at once. It saves the budget on purchasing medical equipment and medicines at each location and avoids expiration dates on medicines. This model is the latest solution to the global health crisis and should be implemented in the near future to combat the emergence and reemergence of new pathogenic microorganisms.

Keywords: abattoir, developing countries, reform, service, veterinary

Procedia PDF Downloads 85
4556 Study of Hypertension at Sohag City: Upper Egypt Experience

Authors: Aly Kassem, Eman Sapet, Eman Abdelbaset, Hosam Mahmoud

Abstract:

Objective: Hypertension is an important public health challenge being one of the most common worldwide disease-affecting human. Our aim is to study the clinical characteristics, therapeutic regimens, treatment compliance, and risk factors in a sector of of hypertensive patients at Sohag City. Subject and Methods: A cross sectional study; conducted in Sohag city; it involved 520 patients; males (45.7 %) and females (54.3 %). Their ages ranged between 35-85 years. BP measurements, BMI, blood glucose, Serum creatinine, urine analysis, serum Lipids, blood picture and ECG were done all the studied patients. Results: Hypertension presented more between non-smokers (72.55%), females (54.3%), educated patients (50.99%) and patients with low SES (54.9%). CAD presented in (51.63%) of patients, while laboratory investigations showed hyperglycaemia in (28.7%), anemia in (18.3%), high serum creatinine level in (8.49%) and proteinuria in (10.45%) of patient. Adequate BP control was achieved in (49.67%); older patients had lower adequacy of BP control in spite of the extensive use of multiple-drug therapy. Most hypertensive patients had more than one coexistent CV risk factor. Aging, being a female (54.3%), DM (32.3%), family history of hypertension (28.7%), family history of CAD (25.4%), and obesity (10%) were the common contributing risk factors. ACE-inhibitors were prescribed in (58.16%), Beta-blockers in (34.64%) of the patients. Monotherapy was prescribed for (41.17%) of the patients. (75.81%) of patients had regular use of their drug regimens. (49.67%) only of patients had their condition under control, the number of drugs was inversely related to BP control. Conclusion: Hypertensive patients in Sohag city had a profile of high CV risks, and poor blood pressure control particularly in the elderly. A multidisciplinary approach for routine clinical check-up, follow-up, physicians and patients training, prescribing simple once-daily regimens and encouraging life style modifications are recommended. Anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance.

Keywords: anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance

Procedia PDF Downloads 305
4555 Condition Monitoring of a 3-Ø Induction Motor by Vibration Spectrum Analysis Using FFT Analyzer- a Case Study

Authors: Adi Narayana S Sudhakar. I

Abstract:

Energy conversion is one of the inevitable parts of any industries. It involves either conversion of mechanical energy in to electrical or vice versa. The later conversion of energy i.e. electrical to mechanical emphasizes the need of motor .Statistics reveals, about 8 % of industries’ annual turnover met on maintenance. Thus substantial numbers of efforts are required to minimize in incurring expenditure met towards break down maintenance. Condition monitoring is one of such techniques based on vibration widely used to recognize premature failures and paves a way to minimize cumbersome involved during breakdown of machinery. The present investigation involves a case study of squirrel cage induction motor (frequently in the electro machines) has been chosen for the conditional monitoring to predict its soundness on the basis of results of FFT analyser. Accelerometer which measures the acceleration converts in to impulses by FFT analyser generates vibration spectrum and time spectrum has been located at various positions on motor under different conditions. Results obtained from the FFT analyzer are compared to that of ISO standard vibration severity charts are taken to predict the preventative condition of considered machinery. Initial inspection of motor revealed that stator faults, broken end rings in rotor, eccentricity faults and misalignment between bearings are trouble shootings areas for present investigation. From the results of the shaft frequencies, it can be perceived that there is a misalignment between the bearings at both the ends. The higher order harmonics of FTF shows the presence of cracks on the race of the bearings at both the ends which are in the incipient stage. Replacement of the bearings at both the drive end (6306) and non-drive end (6206) and the alignment check between the bearings in the shaft are suggested as the constructive measures towards preventive maintenance of considered squirrel cage induction motor.

Keywords: FFT analyser, condition monitoring, vibration spectrum, time spectrum accelerometer

Procedia PDF Downloads 451
4554 Cocoon Characterization of Sericigenous Insects in North-East India and Prospects

Authors: Tarali Kalita, Karabi Dutta

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The North Eastern Region of India, with diverse climatic conditions and a wide range of ecological habitats, makes an ideal natural abode for a good number of silk-producing insects. Cocoon is the economically important life stage from where silk of economic importance is obtained. In recent years, silk-based biomaterials have gained considerable attention, which is dependent on the structure and properties of the silkworm cocoons as well as silk yarn. The present investigation deals with the morphological study of cocoons, including cocoon color, cocoon size, shell weight and shell ratio of eleven different species of silk insects collected from different regions of North East India. The Scanning Electron Microscopic study and X-ray photoelectron spectroscopy were performed to know the arrangement of silk threads in cocoons and the atomic elemental analysis, respectively. Further, collected cocoons were degummed and reeled/spun on a reeling machine or spinning wheel to know the filament length, linear density and tensile strength by using Universal Testing Machine. The study showed significant variation in terms of cocoon color, cocoon shape, cocoon weight and filament packaging. XPS analysis revealed the presence of elements (Mass %) C, N, O, Si and Ca in varying amounts. The wild cocoons showed the presence of Calcium oxalate crystals which makes the cocoons hard and needs further treatment to reel. In the present investigation, the highest percentage of strain (%) and toughness (g/den) were observed in Antheraea assamensis, which implies that the muga silk is a more compact packing of molecules. It is expected that this study will be the basis for further biomimetic studies to design and manufacture artificial fiber composites with novel morphologies and associated material properties.

Keywords: cocoon characterization, north-east India, prospects, silk characterization

Procedia PDF Downloads 90
4553 Clinical Advice Services: Using Lean Chassis to Optimize Nurse-Driven Telephonic Triage of After-Hour Calls from Patients

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

Abstract:

It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

Procedia PDF Downloads 174